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Pharmacologic class: Platelet aggregation inhibitor
Therapeutic class: Antiplatelet agent
Pregnancy risk category B
Decreases platelet aggregation by binding to platelet-receptor glycoprotein, preventing binding of fibrinogen to platelets, which causes thrombus formation
Injection: 10-ml vial (2 mg/ml), 100-ml vial (0.75 mg/ml)
Indications and dosages
➣ Acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction)
Adults: 180 mcg/kg I.V. bolus over 1 to 2 minutes, followed by a continuous infusion of 2 mcg/kg/minute for up to 72 hours
➣ Prevention of thrombosis related to percutaneous coronary intervention (PCI)
Adults: 180 mcg/kg I.V. bolus immediately before PCI, then a continuous infusion of 2 mcg/kg/minute, followed by a second 180-mcg/kg bolus 10 minutes after first bolus. Continue infusion until discharge or for up to 24 hours.
• Renal impairment
• Hypersensitivity to drug or its components
• Severe hypertension
• Bleeding disorders or evidence of active abnormal bleeding within previous 30 days
• Renal dialysis
• Recent cerebrovascular accident
• Recent surgery
• Current or planned administration of another parenteral Gp IIb/IIIa inhibitor
Use cautiously in:
• renal insufficiency
• creatinine level below 2 mg/dl
• platelet count below 100,000/mm3
• elderly patients
• pregnant or breastfeeding patients
• children (safety and efficacy not established).
• Withdraw single bolus dose from 10-ml vial into syringe, and give by I.V. push over 1 to 2 minutes. Follow single I.V. bolus dose with continuous I.V. infusion given undiluted from 100-ml vial spiked with infusion set connected to infusion control device.
• Don't administer through same I.V. line as furosemide.
CNS: headache, dizziness, asthenia, syncope
GI: nausea, diarrhea, constipation
Hematologic: bleeding tendency, thrombocytopenia
Other: bleeding at femoral access site
Drug-drug. Clopidogrel, dipyridamole, nonsteroidal anti-inflammatory drugs, oral anticoagulants, thrombolytics, ticlopidine: increased risk of bleeding Other platelet aggregation inhibitors: serious bleeding
Drug-diagnostic tests. Platelets: decreased count
Drug-herbs. Most commonly used herbs: increased anticoagulant effect of eptifibatide
• Monitor vital signs and assess cardiovascular status, especially for syncope and hypotension.
• Monitor coagulation studies, CBC, and platelet count. Watch for signs and symptoms of abnormal bleeding or bruising and hematuria.
• Check carefully for bleeding at all sites of invasive procedures, particularly femoral access site.
• Tell patient drug may cause serious adverse effects but can help prevent a heart attack. Reassure him that he'll be closely monitored during therapy.
☞ Instruct patient to immediately report fainting or abnormal bruising or bleeding.
• Teach patient safety measures to avoid bruising or bleeding.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.